Ocular surface squamous neoplasia (OSSN) has different treatment modalities. Although
surgical excision has been the gold standard therapeutic option, topical pharmacotherapy
agents such as 5-fluorouracil (5-FU), interferon alfa-2b (IFN) and mitomycin-C (MMC)
are also commonly used. The protocol was registered (CRD42021224961). Comprehensive
literature research was carried out to compare topical pharmacotherapy (5-FU or IFN
or MMC) to surgical excision regarding clinical success (tumor resolution), recurrence
and complications in patients undergoing treatment for OSSN. From 7859 records, 7
articles were included in the qualitative and 4 in the quantitative synthesis. The
outcomes of surgical excision and topical pharmacotherapy were comparable in the included
articles. There were no significant differences between surgical excision and topical
pharmacotherapy regarding the clinical success [odds ratio (OR): 0.785; confidence
interval (CI): 0.130-4.736, P = 0.792)] and tumor recurrence (OR: 0.746; CI: 0.213-2.609;
P = 0.646). The most common side effect of the different therapeutic options was dry
eye. The highest rate of dry eye symptoms was reported after surgical excision (in
59%). Topical pharmacotherapy with all the 3 agents is as effective and well-tolerable
as surgical excision in terms of tumor resolution, recurrence rate and side effects
in all OSSN patients suggesting similar long-term clinical benefits.
